单独胸部或腹部损伤伴或不伴外伤性脑损伤的老年创伤患者，单纯成分治疗与全血加成分治疗相比，单纯全血治疗的临床结果

IF 1.8 3区医学 Q2 SURGERY

Journal of Surgical Research Pub Date : 2025-01-01 Epub Date: 2024-12-28 DOI:10.1016/j.jss.2024.11.046

Hazem Nasef, Nikita Nunes Espat, Brian Chin, Alaina Werling, Quratulain Amin, Caitlin Tweedie, William S Havron, Chadwick Smith, Adel Elkbuli

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引用次数: 0

摘要

前言：本研究旨在评估老年创伤患者孤立性胸部或腹部损伤伴或不伴外伤性脑损伤（TBI）接受全血（WB）、组分（COMP）或WB +组分治疗（WB + COMP）的临床结果。方法:本研究回顾性分析了2017年至2021年美国外科医师学会创伤质量改善项目参与者使用档案数据集，评估了接受WB、COMP或WB + COMP治疗的中重度孤立胸部（简易损伤量表（AIS）胸部≥2）或腹部（AIS腹部≥2）损伤伴或不伴TBI （AIS头部≥2）的老年（年龄≥65岁）创伤患者。和重症监护单位的住院时间。结果：在孤立性胸部损伤的非tbi患者中，COMP患者需要的血浆显著减少（回归系数β = -428 mL， 95%可信区间（CI）： 604 mL-249 mL， P）结论：与WB或WB + COMP相比，COMP治疗显著降低了非tbi患者的输血需求。此外，COMP治疗与孤立性胸部损伤的老年患者24小时死亡率降低有关。单纯胸部损伤的TBI患者在临床结果上无显著差异。有必要进一步研究COMP治疗对TBI患者死亡率结果的潜在益处。

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Clinical Outcomes Following Component Therapy Only Versus Whole Blood Plus Component Versus Whole Blood Only in Geriatric Trauma Patients With Isolated Chest or Abdominal Injuries With or Without Traumatic Brain Injury.

Introduction: This study aims to evaluate clinical outcomes in geriatric trauma patients with isolated chest or abdominal injuries with or without traumatic brain injury (TBI) receiving whole blood (WB), component (COMP), or WB and component therapy (WB + COMP).

Methods: This retrospective analysis of the American College of Surgeons Trauma Quality Improvement Program Participant Use File dataset from 2017 to 2021 evaluated geriatric (age ≥65) trauma patients with moderate-to-severe isolated chest (abbreviated injury scale (AIS) chest ≥2) or abdominal (AIS abdomen ≥2) injuries with or without TBI (AIS head ≥2) receiving WB, COMP, or WB + COMP. Outcomes included emergency department and 24-h mortality, blood product volume (mL) at 4 hs, and intensive care unit-length of stay.

Results: Among non-TBI patients with isolated chest injuries, COMP patients required significantly less plasma (regression coefficient β = -428 mL, 95% confidence interval (CI): 604 mL-249 mL, P < 0.001), and had 48% lower odds of 24-h mortality than WB patients (odds ratio = 0.519, 95% CI: 0.285-0.946, P = 0.032). Among TBI patients with isolated chest injuries, there was no significant association between receiving COMP and plasma volume requirement (β = -166.227, 95% CI: -366.370 to 33.916, P = 0.104) or 24-h mortality (odds ratio = 0.606, 95% CI: 0.301-1.220, P = 0.161) when compared to WB patients.

Conclusions: Compared to WB or WB + COMP, COMP therapy significantly reduced transfusion requirements in non-TBI patients. Additionally, COMP therapy was associated with lower 24-h mortality in geriatric patients with isolated chest injuries. TBI patients with isolated chest injuries had no significant differences in clinical outcomes. Further research is warranted to explore the potential benefits of COMP therapy on mortality outcomes in TBI patients.

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来源期刊

Journal of Surgical Research 医学-外科

CiteScore

3.90

自引率

4.50%

发文量

627

审稿时长

138 days

期刊介绍： The Journal of Surgical Research: Clinical and Laboratory Investigation publishes original articles concerned with clinical and laboratory investigations relevant to surgical practice and teaching. The journal emphasizes reports of clinical investigations or fundamental research bearing directly on surgical management that will be of general interest to a broad range of surgeons and surgical researchers. The articles presented need not have been the products of surgeons or of surgical laboratories. The Journal of Surgical Research also features review articles and special articles relating to educational, research, or social issues of interest to the academic surgical community.